My co-author, Paul DeChant, MD, MBA, and I had the privilege of presenting a workshop at the Institute for Healthcare Improvement’s Annual Forum in early December with Stephen Swensen, MD, medical director for Leadership and Organization Development at the Mayo Clinic.

I was so intrigued by the work that the Mayo Clinic is doing to prevent burnout and restore joy among the work force. I’ll mention here three of the strategies that Swensen described: one overarching approach and two more focused initiatives.

On the large scale, Mayo Clinic has focused intently on the quality of leadership throughout the organization. Every physician rates his or her direct supervisor on a 12-item scale, agreeing or disagreeing with statements such as “My supervisor empowers to do my job” and “My supervisor is interested in my opinion.”

Leaders who rank in the lowest tier are provided with additional leadership training. Those who remain in the lower ranks after training are removed from direct leadership responsibilities.
Why so much focus on leadership? Several reasons, according to Swensen, including the fact that Mayo Clinic research has demonstrated increased rates of burnout among physicians supervised by leaders who score lower on this metric. 

Swensen also described two focused initiatives that I found really fascinating: IT czar and commensality. The IT czar is a designed position filled by personnel with IT (information technology) training and experience. It the responsibility of the IT czar to halt (and potentially reverse) the scope creep associated with the electronic health record (EHR)—a key driver of burnout, as I’ve mentioned in another post.

For any change related to the EHR, the IT czar considers these questions: Do we need to do this electronic work? If so, how can we design it to be performed with the fewest clicks possible? And, who is the right person to be doing this data entry work? Rather than tacking on one functionality after another and pushing more of the data entry work towards physicians (when others could complete it), the IT czar helps keep EHR overwhelm at bay.

Swensen defined commensality as “sharing a meal.” Knowing that physicians have fewer opportunities to connect with their colleagues these days, Mayo Clinic now funds meals several times a month as a means to fight the isolation associated with the fast-paced, digital world. Through the initiative, any group of physicians can request a sponsored breakfast, lunch, or dinner at the health system. Mayo Clinic leaders see the meals as an investment in improving organizational culture and the work life and professional satisfaction of their clinicians.

The Mayo Clinic has been instrumental in studying the prevalence and underlying causes of physician burnout. It’s exciting to see that the organization is translating that knowledge into initiatives that address the causes of burnout at both the individual and system levels.

Questions to consider:

• What larger approaches and focused initiatives is your organization using to address burnout? 
• Which do you wish they were using? 
• In your opinion, why aren’t approaches and initiatives like the ones described in this post used more frequently? Is it lack of understanding about burnout? The pressure of other priorities? 

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